Sasindran Vivek, Moosankutty Sabah, Mathew Nidhi, George Neethu Sara
Department of ENT, Pushpagiri Institute of Medical Science and Research Centre, Thiruvalla, Pathanamthitta, Kerala India.
Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):333-340. doi: 10.1007/s12070-018-1303-x. Epub 2018 Mar 28.
To determine pre and postoperative vocal fold vibratory changes using videostroboscopy (VS) and effect of surgery on functional, physical and emotional levels of voice using voice handicap index (VHI). To determine correlation between VHI and VS in patients with benign vocal fold pathology. This is a prospective study done at Pushpagiri Medical College. 40 patients in the age group of 14-75 years who presented with complaints of voice change were included. VS and VHI of patients done preoperatively in 40 patients. Patients were re-evaluated postoperatively at 1 month by VHI and VS. All patients underwent microlaryngoscopic excision of the benign vocal cord lesion with biopsy under GA in the conventional manner. One month postoperatively, these patients were evaluated by VS and VHI and the findings noted. There was statistically significant improvement in the stroboscopy ratings and VHI scores post operatively ( < 0.0001). The mucosal wave was diminished or absent in 100% of the studied TVC cysts and present in approximately 60% of vocal polyps. There was no significant correlation found between preoperative VHI scores and stroboscopy ratings except for mucosal waves. Whereas there was significant correlation noted between the VHI subscales and total scores with stroboscopic scores postoperatively except for symmetry. All but 6 patients in this study benefitted from surgery and 85% had a normal voice post-operatively. Pre and post operative assessment of patients with benign vocal fold lesions by stroboscopy and VHI is a useful way to determine the degree of improvement following surgery.
使用频闪喉镜(VS)确定术前和术后声带振动变化,以及使用嗓音障碍指数(VHI)评估手术对嗓音功能、生理和情感水平的影响。确定良性声带病变患者中VHI与VS之间的相关性。这是一项在普什帕吉里医学院进行的前瞻性研究。纳入了40例年龄在14 - 75岁、有嗓音改变主诉的患者。对40例患者进行了术前VS和VHI检查。术后1个月通过VHI和VS对患者进行重新评估。所有患者均按照常规方式在全身麻醉下接受了良性声带病变的显微喉镜切除及活检。术后1个月,通过VS和VHI对这些患者进行评估并记录结果。术后频闪喉镜评分和VHI评分有统计学显著改善(<0.0001)。在所有研究的声带囊肿中黏膜波减弱或消失,而在约60%的声带息肉中存在黏膜波。除黏膜波外,术前VHI评分与频闪喉镜评分之间未发现显著相关性。而术后除对称性外,VHI各亚量表及总分与频闪喉镜评分之间存在显著相关性。本研究中除6例患者外所有患者均从手术中获益,85%的患者术后嗓音正常。通过频闪喉镜和VHI对良性声带病变患者进行术前和术后评估是确定手术改善程度的一种有用方法。